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Impact of preterm birth on muscle mass and function: a systematic review and meta-analysis

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Abstract

Individuals born preterm present lower exercise capacity. Along with the cardiopulmonary responses and activity level, muscle strength is a key determinant of exercise capacity. This systematic review aimed to summarize the current knowledge on the impact of preterm birth on skeletal muscle mass and function across the lifespan. The databases PubMed, MEDLINE, EBM, Embase, CINAHL Plus, Global Index Medicus, and Google Scholar were searched using keywords and MeSH terms related to skeletal muscle, preterm birth, and low birth weight. Two independent reviewers undertook study selection, data extraction, and quality appraisal using Covidence review management. Data were pooled to estimate the prematurity effect on muscle mass and function using the R software. From 4378 studies retrieved, 132 were full-text reviewed and 25 met the inclusion/exclusion criteria. Five studies presented a low risk of bias, and 5 had a higher risk of bias due to a lack of adjustment for confounding factors and presenting incomplete outcomes. Meta-analyses of pooled data from homogenous studies indicated a significant reduction in muscle thickness and jump test (muscle power) in individuals born preterm versus full-term with standardized mean difference and confidence interval of − 0.58 (0.27, 0.89) and − 0.45 (0.21, 0.69), respectively.

    Conclusion: Overall, this systematic review summarizing the existing literature on the impact of preterm birth on skeletal muscle indicates emerging evidence that individuals born preterm, display alteration in the development of their skeletal muscle mass and function. This work also highlights a clear knowledge gap in understanding the effect of preterm birth on skeletal muscle development.

What is Known:

• Preterm birth, which occurs at a critical time of skeletal muscle development and maturation, impairs the development of different organs and tissues leading to a higher risk of comorbidities such as cardiovascular diseases.

• Preterm birth is associated with reduced exercise capacity.

What is New:

• Individuals born preterm display alterations in muscle mass and function compared to individuals born at term from infancy to adulthood.

• There is a need to develop preventive or curative interventions to improve skeletal muscle health in preterm-born individuals.

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Data availability

Data is available for sharing upon reasonable request to the corresponding authors.

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Acknowledgements

The authors would like to thank Mi-Suk Kang Dufour for her assistance with the statistical analysis.

Funding

AD was supported by fellowships of the FRQNT (Fonds de recherche du Québec—Nature et Technologies, 275929). JHPB was awarded a fellowship from the CIHR (Canadian Institutes of Health Research MFE-181801). AMN was supported by the Cercle de Sainte-Justine DOHaD Research Chair and a Tier 1 Canada Research Chair in Prematurity and Developmental Origins of Cardiovascular Health and Diseases. TML was supported by a CIHR (PJT-173404) and FRQS (Fonds de Recherche du Québec—Santé) senior award. NAD was supported by a FRQS Junior-2 award, and by a research grant from the CIHR (PJT-174993).

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Authors and Affiliations

  1. Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada

    Alyson Deprez, Jéssica H. Poletto Bonetto, Daniela Ravizzoni Dartora, Philippe Dodin, Anne Monique Nuyt, Thuy Mai Luu & Nicolas A. Dumont

  2. Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada

    Alyson Deprez

  3. Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada

    Anne Monique Nuyt & Thuy Mai Luu

  4. School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada

    Nicolas A. Dumont

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  1. Alyson Deprez
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Contributions

AD and JHPB, conceptualized and designed the study, collected data, carried out the initial analyses, drafted the initial manuscript and revised the manuscript. AD, JHPB, and PD designed the data collection instruments. DRD and AMN, critically reviewed and revised the manuscript. TML and NAD conceptualized and designed the study, coordinated the project, supervised data collection, and critically reviewed and revised the manuscript. AD and JHPB contributed equally.

Corresponding author

Correspondence to Nicolas A. Dumont.

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An ethics statement is not applicable because this study is based exclusively on published literature.

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The authors declare no competing interests.

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Communicated by Gregorio Milani

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Alyson Deprez and Jéssica H. Poletto Bonetto contributed equally.

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Deprez, A., Poletto Bonetto, J.H., Ravizzoni Dartora, D. et al. Impact of preterm birth on muscle mass and function: a systematic review and meta-analysis. Eur J Pediatr 183, 1989–2002 (2024). https://doi.org/10.1007/s00431-023-05410-5

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